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Worksheet 3 - Joint Physical Custody (1 Child) <br />Line Description <br />1 Each Parent's Percent Contribution <br />2 Monthly Support (Worksheet 1 Line 7) <br />3 Joint Physical Support (Line 2 " 1.5) <br />4 !Each Parent's Share (Une 1 • Line 3) <br />5 <br />!No. Days Custody <br />6 ' Percentage of Year (Line 5 / 365) <br />7 Mother's Obligation to Father <br />8 Father's Obligation to Mother <br />1• .9rt <br />._......a Mother's Obligation for Supped <br />10 Children's Health Insurance Premium <br />• 11 Combined Children's Health Insurance Premiums <br />12 ; Each Parent's Share of Premium (Line 11 Line 1) <br />13 !Amount of Premium Paid (Line 10) <br />14 Amount Owed to Other Parent (Line 12 - Line 13) <br />15.a Which Parent Owes Basic Support <br />15.b , Which Parent Owes for Health Insurance <br />15.c :Does the Same Parent Owe on Lines 15a and 15b <br />16 Total Support Owed by Mother (rounded) <br />202305141 <br />• <br />Mother !Father <br />84.32%1 35.88% <br />$1,210.00 <br />$1,815.00 <br />$1,167.41 ! $647.59 <br />182.5182.5 <br />5o% 50% <br />$583.70 <br />$323.80 <br />$250.01..... ... <br />$0.00I $136.10 <br />$136.00 <br />$87.48; $48.52 <br />$0.00 $136.00 <br />$87.48 $0.00 <br />Mother <br />Mother <br />Yes <br />$347.00 <br />Page 35 of 3/0 <br />